Brooks M Blake, D.O.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

L4187 Issued in TX

Practice address

1800 Mormon Mill Rd
Ste A6
Marble Falls, TX 78654-4175

Phone

(830) 798-8000

Fax

(830) 798-8120

NPI assigned

Aug 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brooks M. Blake, DO, PA

  • General Practice Physician
  • Marble Falls, TX
  • NPI 1861660094
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164435236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MORMON MILL RD",
            "address_2": "STE A6",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786544175",
            "telephone_number": "830-798-8000",
            "fax_number": "830-798-8120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MORMON MILL RD",
            "address_2": "STE A6",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786544175",
            "telephone_number": "830-798-8000",
            "fax_number": "830-798-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "BROOKS",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "TX",
            "license": "L4187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0041KC",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Baus, OTD
• Baylor Scott and White
• Raju Behara, MD
• Christina Michelle Belaj, FNP
• Candice Black, AGACNP
• Jennifer M Bliss, M.D.
• Kimberly Michelle Blum, APRN, AGCNS
• Piper Boies-Harris, PT, DPT
• Jimmy Dewayne Bolton Sr., D.C.
• Joan Boughey, C.N.P

• All providers in Marble Falls, TX
• Neuromusculoskeletal Medicine & OMM Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.